Nokea
A 36-year-old woman comes to the clinic complaining of premenstrual syndrome (PMS) that is disrupting her quality of life. What signs and symptoms are associated with this health problem? Select all that apply.
- A. Loss of appetite
- B. Breast tenderness
- C. Depression
- D. Fluid retention
- E. Headache
Correct Answer: B,C,D,E
Rationale: Physiologic symptoms of PMS include headache, breast tenderness, and fluid retention, along with affective symptoms like depression. Loss of appetite is not a common symptom of PMS.
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A nurse is collecting assessment data from a premenopausal patient who states that she does not have menses. What term should the nurse use to document the absence of menstrual flow?
- A. Amenorrhea
- B. Dysmenorrhea
- C. Menorrhagia
- D. Metrorrhagia
Correct Answer: A
Rationale: Amenorrhea refers to the absence of menstrual flow, which aligns with the patient's report. Dysmenorrhea indicates painful menstruation, menorrhagia refers to prolonged or excessive bleeding during menstruation, and metrorrhagia denotes bleeding between periods. Amenorrhea is the correct term for documentation.
A patient who is in the first trimester of pregnancy has experienced an incomplete abortion. The obstetric nurse should prepare the patient for what possible intervention?
- A. Dilation and evacuation
- B. Several days of bed rest
- C. Administration of hydromorphone
- D. IV administration of clomiphene
Correct Answer: A
Rationale: If only some of the tissue is passed, the abortion is referred to as incomplete. An emptying or evacuation procedure (D&C, or dilation and evacuation [D&E]) or administration of oral misoprostol (Cytotec) is usually required to remove the remaining tissue. Bed rest will not necessarily result in the passing of all the tissue. Clomiphene is used for ovulation induction, not abortion management, and hydromorphone is for pain relief, not a primary intervention.
During the nurses assessment of a female patient, the patient reveals that she experienced sexual abuse when she was a young woman. What is the nurses most appropriate response to this disclosure?
- A. Reassure her that this information will be kept a secret.
- B. Begin the process of intensive psychotherapy.
- C. Encourage the patient to phone 911.
- D. Facilitate appropriate resources and referrals.
Correct Answer: D
Rationale: The nurse's primary roles in response to a disclosure of past sexual abuse are to provide empathy and arrange for appropriate resources and referrals, such as counseling or support services. Promising secrecy is inappropriate as confidentiality has limits, psychotherapy is beyond the nurse's scope, and calling 911 is unnecessary for a past event.
A couple has come to the infertility clinic because they have been unable to get pregnant even though they have been trying for over a year. Diagnostic tests are planned for the woman to ascertain if ovulation is regular and whether her endometrium is adequately supported for implantation. What test would the nurse expect to have ordered for this woman?
- A. Serum progesterone
- B. Abdominal CT
- C. Oocyte viability test
- D. Urine testosterone
Correct Answer: A
Rationale: Serum progesterone levels are used to assess ovulation regularity and endometrial support for implantation, key factors in female infertility evaluation. Abdominal CT, oocyte viability tests, and urine testosterone are not standard for this purpose.
The nurse is being trained to perform assessment screenings for abuse on patients who come into the walk-in clinic where the nurse works. Which of the following assessment questions is most appropriate?
- A. Would you describe your relationship as healthy and functional?
- B. Have you ever been forced into sexual activity?
- C. Do you make your husband uncontrollably angry?
- D. How is conflict usually handled in your home?
Correct Answer: B
Rationale: Asking about abuse directly, such as inquiring about forced sexual activity, is effective in identifying the presence of abuse and should be included in the health history of the patients. Oblique questions that relate to the character of the relationship or conflict resolution are less useful clinically. Asking about making a partner angry is inappropriate as it implies blame and does not directly screen for abuse.